Socioeconomic disparities in the utilization of spine augmentation for patients with osteoporotic fractures: an analysis of National Inpatient Sample from 2011 to 2015

Orhurhu, Vwaire; Agudile, Emeka; Chu, Robert; Urits, Ivan; Orhurhu, Mariam Salisu; Viswanath, Omar; Ohuabunwa, Emmanuel C.; Simopoulos, Thomas; Hirsch, Joshua A; Gill, Jatinder

doi:10.1016/j.spinee.2019.11.009

Cited by 14 publications

(12 citation statements)

References 56 publications

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“…The primary outcome of this study was the rate of TKA across racial/ethnic groups and insurance types. We defined race/ethnicity as White, Black, Hispanic, and Asian/Pacific Islander and insurance type as Medicare, Medicaid, private insurance, and self-pay (out of pocket) as has been done in previous studies 24 .…”

Section: Methodsmentioning

confidence: 99%

Racial and Socioeconomic Disparities in the Utilization of TKA Among Patients with Posttraumatic Knee Osteoarthritis

et al. 2022

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Background: Advanced posttraumatic osteoarthritis (PTOA) of the knee is a cause of substantial disability, particularly in younger individuals, and the treatment of choice is total knee arthroplasty (TKA). Racial and socioeconomic disparities exist in the use of TKA, but, to our knowledge, there have been no studies examining these disparities among patients with PTOA. Methods: We performed chi-square and logistic regression analyses on data from the Nationwide Inpatient Sample (NIS). The outcome of interest was the rate of TKA utilization, and the primary predictors were racial/ethnic group and insurance status. The regression models were adjusted for age, sex, household income, and Charlson Comorbidity Index (CCI). Results: The odds of receiving TKA for Black patients (odds ratio [OR] = 0.55; 95% confidence interval [CI], 0.48 to 0.62) and Hispanic patients (OR = 0.53; 95% CI, 0.46 to 0.62) were lower compared with White patients. Patients with Medicare (OR = 0.51; 95% CI, 0.46 to 0.57), those with Medicaid (OR = 0.48; 95% CI, 0.42 to 0.55), and those who self-paid (OR = 0.91, 95% CI: 0.14 to 0.25) had significantly lower odds of TKA compared with those with private insurance. Conclusions: Black and Hispanic patients are less likely than White patients to utilize TKA, and patients with private insurance are more likely to utilize TKA. Level of Evidence: Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.

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Section: Methodsmentioning

confidence: 99%

Racial and Socioeconomic Disparities in the Utilization of TKA Among Patients with Posttraumatic Knee Osteoarthritis

et al. 2022

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“…Considering the 10.3% prevalence of osteoporosis in those older than 50 years 1 combined with the advancing age of the US population, an 8 times increased risk of mortality, 2,3 and a predicted cost of over $1.5 billion annually by 2025, 4,5 the osteoporotic vertebral compression fracture (OVCF) is an important pathology to consider in regard to management as well as more population-based factors such as socioeconomic status, hospital factors, cost, and geographical setting.…”

Section: Introductionmentioning

confidence: 99%

“…Prior studies focused on OVCF procedural management disparities have highlighted differences in operative rates between racial groups and insurance status, as well as a trend of decreasing vertebroplasty rate. 4,7,12,13 Our study aims to expand on current trends and socioeconomic comparison of spinal augmentation procedures for OVCF, as well as perform unique analyses regarding OVCF operative management as it relates to other hospital, geographic, and socioeconomic factors.…”

Section: Introductionmentioning

confidence: 99%

Current Trends and Socioeconomic Disparities in the Utilization of Spine Augmentation for Patients With Osteoporotic Vertebral Compression Fracture: A Nationwide Inpatient Sample Analysis From 2012 to 2016

et al. 2022

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Introduction: Osteoporotic vertebral compression fracture (OVCF) is a growing health care problem in today's aging population. Since the advent of kyphoplasty and vertebroplasty, these interventions have been commonly utilized in the treatment of symptomatic OVCF. However, the use of these interventions varies because there is not a standard of care for the management of OVCF. There remain disparities in the use of these procedures as treatment for OVCFs in the United States.Methods: The 2012 to 2016 Nationwide Inpatient Sample was queried for all patients admitted for OVCF. These patients were then grouped based on whether they received conservative vs surgical (kyphoplasty/vertebroplasty) management and compared with respect to various socioeconomic factors including race, insurance coverage, income quartile, hospital control, and geography. Propensity score matching was utilized to control for potential baseline confounders as well as the influence of other endpoints.Results: The search criteria identified 35,199 patients admitted with OVCF, of whom 7900 (22.4%) received spine augmentation. Blacks/African Americans (risk ratios [RR] = 0.79, P < 0.001), Hispanics/Latinos (RR = 0.82, P < 0.001), Asians/Pacific Islanders (RR = 0.81, P = 0.048), and unknown/other races (RR = 0.88, P = 0.037) were less likely to receive surgical management than whites/Caucasians. When compared with Medicare patients, those with Medicaid (RR = 0.76, P < 0.001) were less likely to receive surgery while privately insured patients were more likely (RR = 1.06, P = 0.42). Patients in the West (RR = 0.90, P < 0.001) were less likely to receive surgery for OVCF than those in the Northeast.Conclusions: A wide variety of socioeconomic disparities exists in the use of spinal augmentation for the management of OVCF in the United States, limiting patient access to a potentially beneficial procedure.Clinical Relevance: Retrospective Analysis.

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“…In severe cases, they can cause kyphosis, which can limit daily activities and reduce quality of life [8,9]. In the most serious case, it can be paralysis or even life-threatening, placing a heavy financial burden on the families of the patients [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Clinical Observation of Intraosseous Anesthesia in Percutaneous Kyphoplasty

Bao

Wang

et al. 2021

Journal of Healthcare Engineering

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Objective. Percutaneous kyphoplasty (PKP) is an effective minimally invasive technique in spine surgery in recent years. General anesthesia and local anesthesia are the main ways of anesthesia in PKP, and epidural anesthesia is also applied to PKP to some extent. However, all these three anesthetic methods have their respective advantages and disadvantages. It is essential to compare and evaluate the effects of different anesthesia methods on PKP for treating spinal fractures. Method. A total of 45 patients (53 vertebral bodies were included) were divided into two groups. Group A included 24 patients (29 vertebral bodies) with an average of 71 years old and Group B included 21 patients (24 vertebral bodies) with an average of 74 years old. Visual analogue scale (VAS) scores were recorded preoperatively; balloon expansion and bone cement injection were conducted intraoperatively. Then, they were recorded immediately after operation, 6 h postoperatively, to assess the pain level of the patient. Moreover, hospitalization time (days), operation duration (minutes), and bone cement injection amount (mL) had also been recorded. Results. There was no significant difference in preoperative general information and VAS score. However, the VAS scores were statistically significant at both the moment of balloon expansion and injection of bone cement. At the moment of immediate postoperation, the VAS scores showed no statistically significant difference, while it showed a statistically significant difference 6 h postoperatively. Conclusion. The anesthesia method by injection of 1% lidocaine hydrochloride (5 ml) into vertebral body can effectively relieve patients’ pain in intraoperation and postoperation.

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Socioeconomic disparities in the utilization of spine augmentation for patients with osteoporotic fractures: an analysis of National Inpatient Sample from 2011 to 2015

Cited by 14 publications

References 56 publications

Racial and Socioeconomic Disparities in the Utilization of TKA Among Patients with Posttraumatic Knee Osteoarthritis

Racial and Socioeconomic Disparities in the Utilization of TKA Among Patients with Posttraumatic Knee Osteoarthritis

Current Trends and Socioeconomic Disparities in the Utilization of Spine Augmentation for Patients With Osteoporotic Vertebral Compression Fracture: A Nationwide Inpatient Sample Analysis From 2012 to 2016

Clinical Observation of Intraosseous Anesthesia in Percutaneous Kyphoplasty

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